Dental health services in Canada

While the Canadian health care system and medical services plans provide coverage for virtually all physician and hospital health care costs, the majority of the responsibility for health care planning and delivery lies with the provinces and territories.

While 70% of the total cost of health care is covered by public insurance, a strong role has always been played by private out-of-pocket and employer-based insurance for services not covered publicly, such as dentistry, drugs and vision care.

For the most part, Canadians are responsible for financing their own dental care and typically do so in the following four ways:

Third-party insurance (employment-related dental coverage),

Private dental insurance (not-employment related coverage),

Directly out-of-pocket, and

Government-subsidized programs.

The sources of funding for dental care services in Canada (and their relative proportions) can be seen in Figure 2. In this chart, for illustrative purposes private insurance refers to all sources of private insurance including employment and non-employment related dental coverage.

Figure 2: Dental Service Expenditures in Canada 2015

Source: Health Expenditure Trends, CIHI, 2015

This figure illustrates how small a proportion public dental services represent compared with other sources of funding for dental services in Canada. Public-sector dental expenditures are targeted primarily to children, seniors, eligible Indigenous individuals and the disabled.

It is estimated that total expenditures on dental services in Canada in 2015 amounted to $13.6 billion. Private-sector expenditures were estimated at $12.7 billion (93.8% of total spending), while public-sector expenditures were estimated at $846 million (6.2% of total spending). Total health care expenditures in Canada in 2015 were estimated at $219.2 billion, meaning that dental expenditures make up about 6.2% of all health care spending in Canada. Private-sector expenditures in health care in 2015 were estimated at $64.2 billion, with dental services spending accounting for one-fifth of the total.

Approximately 60% of all private dental care expenditures originate from private insurance sources and 40% directly out-of-pocket. Therefore, private health insurance plays a crucial role in the provision of dental care in this country.

On a per capita basis, total spending per Canadian on dental services was estimated at $378.60 (compared to $959 on drugs and $946 on physician services). Private per capita spending on dental services was estimated at $355 and public per capita spending at $23.60.

In summary, oral health care occupies a relatively separate position in the Canadian health system. The federal government covers a portion or all of oral health care costs to veterans, refugees and eligible Indigenous individuals and every province recognizes some dental care as medically necessary and "targets oral health care resources to marginalized groups, using different ways and varied health and social services provisions."

Population/dentist ratio

In January 2016, the population/dentist ratio in Canada stood at 1,622, meaning that for every dentist in Canada there are 1,622 people. However, the distribution of dentists varies widely by province (Figure 3) and the ratio has been generally declining over time, signifying that there are increasing numbers of dentists relative to the population and suggesting greater overall availability of oral health care. However, rural and remote areas across Canada have proportionally fewer dentists than urban areas, making access to oral care in these regions more challenging.

Figure 3: Population to Dentist Ratios Canadian Provinces 10 Year Trend (2005 to 2015)